Tag: trial
Music as Therapy in the ICU
Music has been shown to reduce respiratory, cardiac and blood pressure frequencies in response to the reduction of stress hormones. In a randomized clinical trial, it was shown to reduce anxiety and sedation doses/intervals... read more
Long-term Outcomes Associated With Implantable Cardioverter Defibrillator in Adults With CKD
In a large, contemporary, noninterventional study of community-based patients with heart failure and Chronic Kidney Disease (CKD), ICD placement was not significantly associated with improved survival but was associated with... read more
Polymyxin B‑immobilised Hemoperfusion and Mortality in Critically Ill Patients with Sepsis/Septic Shock
Sepsis and septic shock originate from a dysregulated immune response to pathogens and cause millions of deaths worldwide. Endotoxin, a principal component of the outer membrane of Gram-negative bacteria, is a potent trigger... read more
Long-term Recovery Following Critical Illness in an Australian Cohort
Almost all data on 5-year outcomes for critical care survivors come from North America and Europe. The aim of this study was to investigate long-term mortality, physical function, psychological outcomes and health-related... read more
Adjuvant Therapies in Critical Care: Music Therapy
Emerging from the perioperative and oncology fields, music therapy (MT) and patient-directed music interventions (PDMI) have recently garnered interest in the area of critical care. The main goal of these music-based adjuvant... read more
Inspiratory Muscle Training Does Not Improve Clinical Outcomes in 3-week COPD Rehabilitation
The value of inspiratory muscle training (IMT) in pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) is unclear. The RIMTCORE (Routine Inspiratory Muscle Training within COPD Rehabilitation) randomised... read more
Stress Ulcer Prophylaxis in ICU Patients Receiving Enteral Nutrition
Our results suggested that in patients receiving enteral feeding, pharmacologic SUP is not beneficial and combined interventions may even increase the risk of nosocomial pneumonia. We searched PubMed, Embase, and the Cochrane... read more
Do We Need New Trials of Procalcitonin-Guided Antibiotic Therapy?
Using biomarkers as a guide to tailor the duration of antibiotic treatment in respiratory infections is an attractive hypothesis assessed in several studies. Recent work aiming to summarize the evidence assessed the effect... read more
Association Between Fluid Balance and Outcomes in Critically Ill Children
Fluid overload is common and is associated with substantial morbidity and mortality in critically ill children. Additional research should now ideally focus on interventions aimed to mitigate the potential for harm associated... read more
The ADRENAL Trial: Steroids in Septic Shock
Randomized clinical trials evaluating the efficacy of adjunctive corticosteroids in septic shock have shown conflicting evidence of clinical relevance. Two trials in particular looked at lower dose hydrocortisone (200mg/day)... read more
Barriers and Facilitators to Early Rehabilitation in Mechanically Ventilated Patients
Using a theoretically driven approach, this study identified important barriers and facilitators to early rehabilitation in ICU patients. In particular, the domains of social influences and behavioral regulation were not... read more
Supplemental Parenteral Nutrition vs. Usual Care in Critically Ill Adults
This individually titrated supplemental PN strategy applied over 7 days significantly increased energy delivery when compared to usual care delivery. Clinical and functional outcomes were similar between the two patient groups.... read more
Glycaemic Control Targets After TBI
This meta-analysis of intensive glycaemic control shows no association with reduced mortality in TBI. Intensive glucose control showed a borderline significant reduction in the risk of poor neurological outcome, but markedly... read more
Comparison between a nurse-led weaning protocol and weaning based on physician’s clinical judgment in tracheostomized critically ill patients
In this pilot RCT we demonstrated that a nurse-led weaning protocol from tracheostomy was feasible and safe. A larger RCT is justified to assess efficacy. We enrolled 65 patients, 27 were in the protocol group and 38 in the... read more
Predictors of Intubation in Patients With AHRF Treated With a Noninvasive Oxygenation Strategy
In patients with acute hypoxemic respiratory failure breathing spontaneously, the respiratory rate was a predictor of intubation under standard oxygen, but not under high-flow nasal cannula oxygen or noninvasive ventilation.... read more
Dexmedetomidine Prevents AKI After Adult Cardiac Surgery
Perioperative administration of dexmedetomidine in adult patients undergoing cardiac surgery may reduce the incidence of postoperative AKI. Future trials are needed to determine the dose and timing of dexmedetomidine in improving... read more
An Interprofessional Quality Improvement Initiative to Standardize Pediatric Extubation Readiness Assessment
An interprofessionally developed respiratory therapist–led extubation readiness protocol can be successfully implemented in a busy tertiary care PICU without adverse events. We analyzed data from 398 mechanically ventilated... read more
The Case of the Relative Insufficiency
When it comes to the efficacy of glucocorticoid therapy for the treatment of septic shock, we have existed in a state of ambiguity, torn between the results of two contradictory RCTs. The first, the Annane et al trial published... read more
Pooled analysis of higher versus lower blood pressure targets for vasopressor therapy septic and vasodilatory shock
Targeting higher blood pressure targets may increase mortality in patients who have been treated with vasopressors for more than 6 h. Lower blood pressure targets were not associated with patient‑important adverse events... read more
Hypothermia in Sepsis – The CASS Trial
Sepsis and especially septic shock (no matter what definition you use) is a recipe for multi-organ dysfunction and poor prognosis. In the past few years, we saw a lot of failed attempts trying to find something that could... read more
High Frequency Percussive Ventilation Increases Alveolar Recruitment in Early ARDS
High frequency percussive ventilation (HFPV) combines diffusive (high frequency mini-bursts) and convective ventilation patterns. Benefits include enhanced oxygenation and hemodynamics, and alveolar recruitment, while providing... read more
